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Supportive Care in Cancer

, Volume 15, Issue 6, pp 643–647 | Cite as

Dexamethasone for the prophylaxis of radiation-induced pain flare after palliative radiotherapy for bone metastases—a pilot study

  • Edward ChowEmail author
  • Andrew Loblaw
  • Kristin Harris
  • Meagan Doyle
  • Philiz Goh
  • Hannah Chiu
  • Tony Panzarella
  • May Tsao
  • Elizabeth A. Barnes
  • Emily Sinclair
  • Macey Farhadian
  • Cyril Danjoux
Short Communication

Abstract

Purpose

To investigate the efficacy of dexamethasone as a prophylactic adjuvant analgesic to decrease pain flare and to assess its safety and tolerance of dexamethasone.

Materials and methods

Patients treated with a single 8 Gy for bone metastases took 8 mg dexamethasone before the radiation treatment. The Brief Pain Inventory was administered at baseline and then daily for 10 days after radiation. Pain flare was defined as a two-point increase in the worst pain or a 25% increase in the analgesic intake when compared with the baseline.

Results

Thirty-three patients (23 males, 10 females) had complete follow-up data. Their median age was 73 years old. Ten patients had progressive worsening pain during the entire 10-day follow-up. A total of eight patients (24%; 95% CI, 10–39%) experienced pain flare during the 10-day follow-up. Two patients had a 1-day pain flare on day 3. Three patients had a 1-day pain flare on day 7. Three other patients had a prolonged pain flare: one had a 3-day pain flare on days 2–4, one had a 3-day pain flare on days 4–6, and the other, a 6-day pain flare on days 3–8. The half-life of dexamethasone is 36–54 h. Only one patient (3%) experienced pain flare in the first 2 days of follow-up with the action of dexamethasone. Dexamethasone was well tolerated.

Conclusion

Dexamethasone might be effective in the prophylaxis of radiation-induced pain flare after palliative radiotherapy for bone metastases. Randomized trials are required to confirm the finding.

Keywords

Dexamethasone Pain flare Bone metastases Palliative radiotherapy 

Notes

Acknowledgements

We thank the staff and the students in the accrual. This study was supported by Michael and Karen Goldstein Cancer Research Fund. Drs. Chow and Loblaw were the co-PIs of this study.

References

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Edward Chow
    • 1
    • 2
    Email author
  • Andrew Loblaw
    • 1
  • Kristin Harris
    • 1
  • Meagan Doyle
    • 1
  • Philiz Goh
    • 1
  • Hannah Chiu
    • 1
  • Tony Panzarella
    • 1
  • May Tsao
    • 1
  • Elizabeth A. Barnes
    • 1
  • Emily Sinclair
    • 1
  • Macey Farhadian
    • 1
  • Cyril Danjoux
    • 1
  1. 1.Rapid Response Radiotherapy Program, Toronto Sunnybrook Regional Cancer CenterUniversity of TorontoTorontoCanada
  2. 2.Department of Radiation OncologyToronto Sunnybrook Regional Cancer CentreTorontoCanada

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